What Causes Male Pattern Baldness?
Male pattern baldness is a common type of hair loss in men. It’s often an inherited condition, which means it’s not easy to prevent it from happening.
Male pattern baldness occurs when the hair follicles on your scalp shrink. Over time, the follicles will shrink so much that a strand of hair cannot grow from it. This leads to baldness.
You can slow down the progression of male pattern baldness using certain hair loss treatments for men. These include finasteride, Propecia and minoxidil.
What is male pattern baldness?
Male pattern baldness is a type of hair loss in men. It’s also known as androgenic alopecia or androgenetic alopecia. You may have a higher risk of getting male pattern baldness if you have a family history of hair loss.
Hair loss occurs when your hair follicles shrink to the point where new hair cannot grow in a process called miniaturisation.
This process does not happen immediately. First, the hair follicle will shrink so that your hair becomes shorter. During this stage you might notice your hair falling out easily or thinning hair. Over time, the hair follicle will shrink completely.
Male sex hormones (also called androgens) are linked to male pattern hair loss. Both men and women have androgen hormones, such as testosterone. This type of hair loss in women is called female pattern baldness.
If you have too much of an androgen called dihydrotestosterone (DHT), you might be at risk of hair loss. DHT is made from testosterone in your body. DHT is a powerful type of androgen. When it binds to the same receptors that testosterone does, it creates a greater effect.
When DHT binds to an androgen receptor, it starts the process of hair miniaturisation. You have more androgen receptors in the front of your scalp than at the back or sides. This can explain why you might be losing hair or finding bald patches near your hairline more than anywhere else on your scalp.
By suppressing the amount of DHT in your scalp, we can slow down and prevent the process of hair loss. Interestingly, the presence of DHT in other parts of your body, like your beard line or chest, can cause an increase in hair growth.
The process of hair loss is complex as it involves different hormones, receptors and enzymes. From current research, we can be certain that DHT plays a big part in causing male pattern baldness.
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What age does male pattern baldness start?
Male pattern baldness can start at any age. Factors like genetics, stress and illness can play a part in how soon you start losing hair. If hair loss runs in your family, you may notice the signs of hair loss before you reach the age of 21. This can happen to around a quarter of men that have hereditary hair loss.
Some boys might notice a receding hairline even as early as 15 years old, though this is in extreme cases.
Causes of male pattern baldness
Male pattern baldness can be caused by several different factors. A common cause of hair loss in men is genetics. If you have a family history of hair loss, even if it is from the women in your family, you’re more likely to experience hair loss.
Other causes of hair loss in men include:
- nutritional deficiency, including vitamins A, B, C, D, E and iron
- illnesses such as alopecia areata or thyroid conditions
Certain medications can have side effects of hair loss. These include medications used in chemotherapy, acne treatment and immunosuppressants. Hair loss as a medication side effect is usually temporary and will not last very long. If you’re concerned that your medication is causing hair loss, speak to your doctor or pharmacist.
How to stop or slow down male pattern baldness
You may not be able to stop the process of male pattern baldness completely, especially if it is an inherited condition. Try to take care of your scalp health by doing regular scalp massages, quitting smoking and managing stress.
If you currently have male pattern baldness, there are some treatment options you can try to reverse the process. Note that these treatments will not work if you have complete baldness as your hair follicles will have shrunk completely.
Treatment for male pattern baldness
Finasteride is a prescription-only medication that is used to slow down the process of male hair loss. Finasteride 1mg tablets are taken daily. You’ll usually only start to see an improvement after 3 to 6 months of use. Finasteride only works while you are taking it, after stopping treatment, the results will start to reverse with a return to baseline being seen by 9 to 12 months. Finasteride is also available under the brand name Propecia.
Minoxidil is a hair loss treatment that is available over the counter. You can buy minoxidil as a scalp foam under the brand name Regaine. You should use minoxidil for up to 4 months to allow time for your scalp to be treated. If you do not see any improvement after 4 months, speak to your doctor.
If medication treatments do not work for you, you may consider getting a hair transplant. Hair transplant surgery is not available on the NHS, so you’ll need to find a private clinic to discuss your treatment.
Hair loss is a personal condition that can affect your self esteem. It’s important not to overlook the mental effect that this medical condition can have on you. You can find support groups, such as Alopecia UK, to help connect you with others going through the same condition.
Dr Kathryn Basford
Dr Kathryn Basford is a qualified GP who works as a GP in London, as well as with ZAVA. She graduated from the University of Manchester and completed her GP training through Whipps Cross Hospital in London.Meet our doctors
Last reviewed: 22 Jun 2022
Assessment of the usefulness of dihydrotestosterone in the diagnostics of patients with androgenetic alopecia [Aug 2014] [accessed April 2022]
A bald statement — Current approaches to manipulate miniaturisation focus only on promoting hair growth [May 2018] [accessed April 2022]
Men’s Hair Loss – American Hair Loss Association [accessed April 2022]
What You Need to Know About DHT and Hair Loss (Healthline) [Jan 2019] [accessed April 2022]
Male pattern hair loss (male androgenetic alopecia) (NICE CKS) [Feb 2022] [accessed April 2022]
(Reviews are for ZAVA UK)